Abstract
While official national unemployment estimates hover between 5-7%, reported unemployment for persons with disabilities are almost ten times that, estimated at a disturbing 70% (National Organization on Disability, 2000). A significant majority of unemployed persons with disabilities want to work, but the sharp increase in persons receiving Social Security Disability Income (SSDI) or Supplemental Security Income (SSI) benefits in the past five years belies state and federal efforts to wean people from benefits they need to survive. To return to work for many would be to jeopardize health insurance coverage, a sig- nificantly stronger disincentive than is the promise of increased earnings. It became clear to many disability policy analysts and the disability community that even after passage of the Americans with Disabilities Act (ADA), additional legislation would be needed to balance the intent of state and federal programs to assure minimal social security with the goal of increasing independence and social integration among persons with disabilities seeking work. State Medicaid programs were viewed as one vehicle for helping achieve this balance.